844 INFLAMMATION OF THE FLEXOR TENDONS. 



iodine causes them to be most widely used. A mixture of 

 unguentum hydrargyri and sapo viridis in equal quantities can be 

 used, with double the amount of lanoline where massage seems 

 called for. Warm baths of soap or weak potash solution consider- 

 ably assist absorption. 



The action of blisters is largely due to the mechanical effect of 

 infriction and the pressure of the cutaneous thickening on the inflamed 

 spot ; and when the above-described treatment proves impracticable, 

 it is good practice to apply a blister, or better still, a blistering 

 plaster. The use of " charges," though now almost discontinued, 

 is of considerable value in many cases of strained tendons. Roborans 

 plaster, liquefied by heat, is spread thinly over linen strips and applied 

 with gentle pressure from the fetlock to within an inch or two of 

 the flexure of the knee. Occasionally the liquid plaster is applied 

 to the skin and is covered with finely chopped tow ; but the former 

 method is the better. The charge is left on for six to eight weeks, 

 provided no complications ensue. This method is less likely to 

 blemish than the use of blisters. Potting assists the action of the 

 blister by a pressure dressing. About the third day, when exudation 

 has ceased, he applies moist wadding to either side of the diseased 

 tendon and passes a woollen bandage over all. The first dressing 

 remains on for two days, and is then renewed and left in place for 

 three to five days. 



For perforates strain, Joly advises peritendinous insufflation 

 of filtered air, followed by massage. This treatment is carried out, 

 with due regard to antiseptic precautions, in the standing or recum- 

 bent position. A tourniquet is applied to the fore-arm. The air 

 drawn through iodoform gauze is slowly injected by means of a 

 Potain's aspirator furnished with a fine needle, which is pushed into 

 the subcutaneous tissues over the distension on the posterior line 

 of the leg. When the air has penetrated the healthy, cedematous 

 or indurated tissues of the strained part, the needle is withdrawn 

 and the puncture closed with collodion. Next day the insufflated 

 region should be gently kneaded to drive the air, which tends to 

 spread excentrically, into the meshes of the inflamed tissues. 

 Massage is repeated morning and evening at the most distended 

 parts and finally the leg is douched with cold water. By this method, 

 Joly states, that the effects of peritendinitis are rapidly and 

 radically reduced, and that the indurated centre of tendinitis is 

 quickly isolated and often reduced as well. In 15 days, in certain 

 cases, the tendon has become perfectly cool, clean, insensitive, and 

 resistent to the effects of work. 



